Oral Health Watch

Study Suggests Oral Care Should Begin Prior to Teething

Oral health care in infants should start before teeth even appear, according to study findings published in PLoS One in August 2011, which confirm the presence of bacteria associated with early childhood caries (ECC) in infant saliva.

ECC is a virulent form of caries more commonly known as cavities, which affect nearly 40% of children by the time they reach kindergarten, according to Kelly Swanson, MS, PhD, of the University of Illinois, the study’s lead researcher.

In the study, Dr. Swanson and colleagues used high-throughput molecular techniques to characterize the entire community of oral microbiota in infants, a group that has not been the focus of many studies focusing on oral care.

Through 454 pyrosequencing, researchers learned that the oral bacterial community in infants without teeth was much more diverse than expected, and identified hundreds of species. The finding that multiple members of the bacterial community that are linked to ECC are already present in infant saliva justifies further research on the evolution of the infant oral bacterial community.

“We now recognize that the ‘window of infectivity,’ which was thought to occur between 19 and 33 months of age, really occurs at a much younger age,” he said. “Minimizing snacks and drinks with fermentable sugars and wiping the gums of babies without teeth, as suggested by the American Academy of Pediatric Dentistry, are important practices for new parents to follow to help prevent future cavities.”

Millions of Americans Lack Access to Oral Health Services

A new report from the Institute of Medicine and National Research Council found that millions of Americans don’t receive dental health services—a statistic that can be attributed to economic, geographic, and culture barriers.

According to the report, approximately 33.3 million people live in areas with shortages of dental health professionals. In 2008, 4.6 million children did not obtain needed dental care because their families could not afford it. And in 2006, only 38% of retirees had dental coverage, which is not covered by Medicare.

“The consequences of insufficient access to oral health care and resultant poor oral health—at both the individual and population levels—are far-reaching,” said Frederick Rivara, MD, MPH, Seattle Children’s Guild Endowed Chair in Pediatrics at the University of Washington School of Medicine, Seattle. “As the nation struggles to address the larger systemic issues of access to health care, we need to ensure that oral health is recognized as a basic component of overall health.”

Lack of regular oral health care has serious consequences, the report noted, including increased risk of respiratory disease, cardiovascular disease, and diabetes, and inappropriate use of hospital emergency departments for preventable dental diseases.

To remove these barriers, the authors recommend changing funding and reimbursement for dental care; expanding the oral health workforce by training doctors, nurses, and other non-dental professionals to recognize risk for oral diseases; and revamping regulatory, educational, and administrative practices. For more information, visit www.iom.edu.

The American Pharmacists Association (APhA) is teaming up with several organizations, including the American Dental Association (ADA), to promote oral health and raise public awareness of dry mouth, a common side effect of taking prescription and OTC medications.

According to the ADA, more than 500 medications can contribute to oral dryness, including antihistamines, antihypertensive medications, decongestants, pain medications, diuretics, and antidepressants. In its most severe form, dry mouth can lead to extensive tooth decay, mouth sores, and oral infections, particularly among the elderly.

By joining together, the associations seek to expand awareness of the impact of medications on dry mouth, a condition that impacts at least 25 million Americans. Although short-term oral dryness occurs frequently and is not cause for concern, chronic cases of dry mouth can persist for longer periods of time, and can result in bad breath, denture sores, dry and cracked lips, and increased risk of oral infection.

Common symptoms of dry mouth include trouble eating, speaking, and chewing, burning sensations, or a frequent need to sip water while eating.

Individuals with dry mouth should have regular dental checkups, and are advised to “carry an up-to-date medication list at all times, and tell your dentist what medications you are taking,” said Thomas Menighan, executive vice president and chief executive officer of APhA. “In some cases, a different medication can be provided or your dosage modified to alleviate dry mouth symptoms.”

To help relieve symptoms, patients are also advised to increase fluid intake, chew sugarless gum, take frequent sips of water, and avoid tobacco, caffeine, alcohol, and carbonated beverages.